Hospitals, doctors' offices and long-term care facilities have a large proportion of patients who are diabetic and require monitoring of their blood glucose levels by healthcare professionals (HCPs). For non-critically ill patients, this is usually carried out using a blood glucose meter and associated disposable test strips. The patient donates a sample of blood which is added to a disposable test strip which is inserted into the blood glucose meter. Inevitably, the process of obtaining the blood sample from the patient may result in spillage of blood onto the blood glucose meter, thereby resulting in potential contamination of the surfaces of the meter. The meter itself is non-disposable and may be used for several thousands of patients. The meter and test strips are typically carried around on a moveable med cart during rounds at the facility. Alternatively, the meter may be kept at a central station.
The blood glucose meters are used on multiple patients, thereby exposing them to bodily fluids such as blood, plasma, saliva, urine and faeces, which may carry infectious agents. Additional sources of chronic infection may also be present in the hospital, including workers, visitors, food, unclean surfaces and solutions. Many hospital and nursing home environments suffer from highly resistant contaminations, such as C difficile, Pseudomonas, TB and MRSA, which may be a source of infection. Devices such as glucose monitors must be carefully and thoroughly disinfected between use on multiple patients and after use, to prevent contamination being passed to patients.
The Center for Disease Control (CDC) has recently promulgated much stricter guidelines on disinfection of medical devices, including glucose meters, when used on multiple patients. In many states, these regulations are enforced by inspectors. In particular, these guidelines mandate that the meters be disinfected for requisite periods with EPA-registered pre-wetted wipes. The period of cleaning is described in the claims on the EPA-registered wipes, and the meters must be wrapped in the wipes and kept moist during the cleaning process. Thus, if a disinfection wipe has a 3 minute kill time for C difficile and other pathogens, the surface of the blood glucose meter must be kept moist/wet for at least 3 minutes.
The problem for HPCs is having a means of monitoring the period of disinfection and ensuring that the meter they are using is properly disinfected before use on another patient. In a busy hospital with many patients and multiple meters, this is difficult to monitor.
Disinfection periods for difficult-to-kill bacteria may be of several minutes even using bleach wipes (usually the most effective cleaning agent). The HCPs may have multiple patients to visit/monitor blood sugars. Ideally they need a device which will allow disinfection of one blood glucose meter while another is being used. Such a device must allow the minimum of steps, be easy to use, and indicate when a meter has been disinfected.